-Medical Informatics and Telemedicine conference-

Meditel 2008
The use of ICT ( Information and communication technologies) for Health care in India is still very limited. Most of the efforts in this direction are sporadic and rudderless.There is no dearth of skilled manpower in this field, but a unified plan of action is still awaited.

Medical computer society of India has taken the lead to organize a national conference on Medical informatics and Telemedicine. Under the leadership of Dr.Sunil Shroff, eminent Nephrologist and President of MCSI, the fifth national conference on Medical informatics and telemedicine is scheduled to take place at Sri Ramchandra Medical College & Research Institute, Chennai on 19th-20th December, 2008.

“The conference (as in the past) will bring together decision makers, policy makers, practicing clinicians, healthcare educators and researchers, health administrators, health technologists and IT vendors.Meditel 2008 offers a platform to meet, interact and network with qualified specialists, users, buyers, healthcare providers, industry representatives, researchers and policy makers from India and abroad.“

I was a part of Meditel 2006 and can vouch for the quality of discussions held at Centre for Digital Health, Amrita institute of Medical Sciences, Kochi, Kerala.It proved extremely useful to me then and I expect a similar experience this year.

- No green beards in path labs @ John Hopkins University

The pathology department at my medical college was very strict with us Resident doctors. All our activities were constantly noted by our seniors, and being reprimanded  frequently for “unprofessional conduct” was the norm. Our seniors made sure we were always properly dressed and behaved.

But what i read on John Hopkins university, Dept. of Pathology website takes the cake. They have a detailed list of “acceptable” and “unacceptable” conduct. Sample a few,

1) Acceptable- Knee length culottes and dress shorts; Unacceptable- Mini skirts, blue jeans, baseball caps.

2) Acceptable- Fingernails that are of “professional length”, whatever that means; Unacceptable- Applying cosmetics in the laboratory.

3) Acceptable- Short/ Tied back hair of natural color ; Unacceptable- Purple and Green beards and mustaches!!

4) Acceptable- Socks/ Hose/ Tights ; Unacceptable- Printed underwear showing through outer garments.

5) Acceptable- Jewelery in moderation ; Unacceptable- Badges promoting causes/products/slogans NOT endorsed by the Institution/department.

Its definitely a good read. Click here to access the pdf file of acceptable appearance standards at John Hopkins University.

-Why American healthcare is so expensive?

That the American healthcare delivery system is out of control and wasteful is a no-brainer.

Needless battery of investigations and over diagnosis, branded drugs, impractical insurance laws, free-markets approach to health care and sedentary lifestyle are all major factors in creating the current scenario.Its like a bad spiraling black hole which only sucks you into unnecessary and wasteful consumption of health services.

Keeping the whole machinery ticking seems to be the raison d’itre de patient existence.

This video below touches on a few reasons on why health care is so expensive in America. Features like this convince that India must be doing something right in its public health policy. I have been a member of Public health delivery system for about 10 years, in a wide range of positions and institutions. I fully appreciate Indian obstacles (population) and limitations (poverty) in public health delivery. A good step has been taken with the Swasthya bima (govt. sponsored health insurance with private partners). This Indian central govt scheme for BPL (Below poverty line) families is built on sound understanding of indian conditions and mindset. Eighteen states, including Rajasthan, have already launched this scheme. What is needed now is to make sure ALL BPL families OBTAIN an insurance smartcard. NGOs need to come forward to ensure all BPL families get their smartcards. The cost of the insurance is Ruppees 750/- annualy, 75% paid by central govt. and 25% state govt. The consumer would have to pay an annual Ruppees (Thirty) 30/- as registration/renewal fees. Then they would able to use all public hospitals, many private hospitals and most specialist health care institutions all over the country with the help of a single smartcard!! The claims section of the scheme still has to show efficiency. But all in all, its a very well thought out scheme and should work wonders in more ways than one.This would also have a trigerring effect for adoption of EMR(Electronic medical records).

http://www.youtube.com/watch?v=JYC2DJWU41s

-Where are the Doctors?, says “Assocham”, Indian industries.

India lags in primary health, lacks specialists : iGovernment

New Delhi: About 50 per cent of sanctioned posts of specialists
at various community health centres (CHCs) throughout India are vacant,
which shows that the primary health still remains the lowest priority
of state governments including union territories, reveals an industry
lobby report.

According to the Associated Chamber of Commerce
and Industries (Assocham) Paper ‘Role of Health Insurance in Medical
Care in India’, 59.2 per cent of posts of surgeons, 46.4 per cent of
obstetricians and gynaecologists, 56.6 per cent of physicians and 51.9
per cent of pediatricians are vacant in the 4,500 CHCs in the country.

Releasing
the paper, Assocham President Sajjan Jindal said that 2,525 CHCs should
have been added to current operational community health centres that
number around 5,000 by end of 2007-08 which did not happen at all,
speaks of utter apathy that state governments observed towards them.
 
The
CHCs are supposed to provide specialised medical care in the form of
facilities of surgeons, obstetricians and gynaecologists, physicians
and paediatricians throughout the country to promote rural health.

Even
out of the sanctioned posts, a significant percentage of posts are
vacant at other levels. For instance, about 8.8 per cent of the
sanctioned posts of female health worker are vacant as compared to
about 32 per cent of the male health worker.

At primary health
centres (PHCs), about 13.8 per cent of the sanctioned posts of female
health assistant and 22.1 per cent of male health assistant are vacant.
 
At
the sub centre level, the extent of existing manpower can be assessed
from the fact that about five per cent of the sub centres were without
a female health worker, about 37.2 per cent sub centres were without a
male health worker and about 4.7 per cent sub centres were without both
female health worker as well as male health worker.

This
indicates a large shortfall in male health workers, resulting in poor
male participation in family welfare and other health programmes, the
Assocham paper said.
 
About 5.6 per cent of the PHCs were
without a doctor, about 40 per cent were without a lab technician and
about 17 per cent were without a pharmacist.

The chamber has,
therefore, recommended that states who manage these centres should
attach equal priority to their well being just as they take up issues
of creating infrastructure such as roads, ports and aviation.

-Palliative care in Cancer-

Most People do not realize the importance of palliative care. in Cancer.

Palliative care (from Latin palliare, to cloak) is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than striving to halt, delay or reverse progression of the disease itself or provide a cure. Palliative care is an interdisciplinary team approach, with a
focus on comfort and quality of life rather than prolongation of life
or “cure” for a patient.

With better drugs and technology, we are dramatically improving the survival in cancer patients. New studies are carried out everyday to find new cures.Unfortunately, the research frequently focuses exclusively on
survival as an endpoint, leaving surgeons with little information on an
intervention’s impact on QOL (Quality of Life).

There are multiple examples of problems that can affect the QOL for a
patient facing the end of life. These can be categorized based on
symptoms or systems in the body that are affected. Major symptoms
include pain, dyspnea, anorexia, and depression. Related to body
systems, one can imagine a potential symptom related to each body
system. Neurologic problems include fatigue, headache and other pain
syndromes, and delirium. Pulmonary complications include dyspnea,
fatigue, and immobility. Cardiac symptoms include shortness of breath,
fatigue, and pain. Gastrointestinal problems include obstructions,
diarrhea, nausea, vomiting, and anorexia. Musculoskeletal complications
include fractures, functional loss, and pain. Epidermal problems mainly
focus on wound problems, but also can include poor cosmesis and pain.
Complications related to the hematologic system include infection and
fatigue. Urologic problems include ureteral obstructions, bleeding, and
pain. It is this compendium of problems that palliative care research
focuses on, rather than increase in survival time or cure. We need research to also focus on these problems of the people who survive cancer.

There are many potential reasons for the lack of palliative care
research. Many of them are related to ethical aspects of this research.
There are also innate barriers, such as a lack of trained researchers
and the challenges of subject recruitment.

For the original article, click here.

- Better radiotherapy at Tata memorial cancer Hospital-

I am referring here to something which appears under the heading (?)
Official Google Blog.

“One of India’s leading cancer hospitals will expand its program of
advanced whole-body radiosurgery with the acquisition of a
Varian/BrainLAB Novalis Tx™ radiosurgery platform”

“Varian and BrainLAB joined forces late last year to introduce the
Novalis Tx and Tata Memorial is the first hospital in India to order
this advanced solution”

“Novalis Tx offers radiosurgery for malignant and benign lesions
throughout the body, arteriovascular malformations, and functional
lesions. It features very high dose delivery rates, which means that
treatments can be delivered very rapidly. Novalis Tx also offers
dynamic ultra-fine beam shaping and frameless patient positioning for
more rapid and comfortable treatments. The platform also includes an
On-Board Imager® device for pinpointing the tumor and positioning the
patient with sub-millimeter precision”

Tata memorial has always been one of India”s finest cancer hospitals and it is not surprising that the hospital has teamed up with Varian medical systems( Paolo Alto, California) and BrainLAB ( Munich, Germany) to offer better and more precise radiotherapy to its patients. Good use of technology and software for better health care. I love it!!

I have been a longtime fan of Dr.Anita Borges, Pathologist @ Tata memorial cancer hospital and i know that Tata memorial cancer hospital will make good use of its superb diagnostic and treatment resources.

Catch cancer early and “fry” it precisely.